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Long Term Care Planning For The Future. What You Need to Know. Goals for Learning. Increase knowledge of the different types of long term care Increase understanding of factors to consider in choosing long term care options Increase understanding of how to pay for long term care options
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Long Term CarePlanning For The Future What You Need to Know
Goals for Learning • Increase knowledge of the different types of long term care • Increase understanding of factors to consider in choosing long term care options • Increase understanding of how to pay for long term care options • Increase knowledge of local resources and services
What Is Long Term Care? • The provision of care and services, prompted by either chronic illness, injury, frailty or dementia. • Support for activities of daily living and nursing care as needed. • A need for these services for many months, years, or the rest of your life.
What are Activities of Daily Living? • EATING/FEEDING • BATHING/DRESSING • MOBILITY/TRANSFERS • TOILETING/CONTINENCE CARE
What are Instrumental Activities of Daily Living? • SHOPPING • HANDLING FINANCES • CLEANING/LAUNDRY • USING TRANSPORTATION • PREPARING MEALS • TAKING MEDICATIONS
Case Examples • Louise • Bella Vista Assisted Living for 5 years • Exhausting finances • Ruth • Living alone, children live out of town • Difficulty managing alone; confused
You Or Someone You Know Will Need Long Term Care Services • Women who reach the age of 65 are likely to live 19 additional years, for males—16 additional years. • 8.5 million people over the age of 70 have limitations with their ADLs or IADLs • The longer you live, the greater your chances of needing long term care services.
How Likely Are You To Spend Time In A Nursing Home? • 1 in 3 persons who live to age 65 will spend one to three months in a nursing home. • One in 4 will spend one year or more. • The average length of stay is 19 months. • Women are more likely to need nursing home care (they live longer).
Caregivers • Family Caregivers provide 80 to 90% of all long term care • Trends that impact family care giving: • Fewer children • People live to be much older • Families live far apart
Long Term Care Continuum • Support Services for persons living at home • Residential Options • Simple services to very complex services to meet personal and medical needs
1. Some Of The Support Services For Individuals Living At Home Are: • Adult Day Services • Home Delivered Meals • Homemaker • Medications Management • Personal Care Assistance • Personal Emergency Response System
1-888-456-5664 • Information about Services is available from the: Area Agency on Aging of Western Michigan
In-Home Services Are Available From Many Programs • FIA Home Help Program • Veteran’s Assistance • Care Management • MI-Choice Waiver • Hospice
2.Residential Options • Informal Options • Assisted Living • Licensed • Unlicensed • Adult Foster Care • Home for the Aged • Nursing Home • Continuing Care Retirement Communities
1-800-782-2918 • For Information about residential options call: Citizens for Better Care
You’ll need to Know • Assisted living is not a legal designation • Licensing—benefits • State inspection reports and other quality of care information
When Is It Time To Move? • When more help or a move is needed • Caregiver burnout • Increased care needs • Health and or Safety • Quality of Life • Exhausted financial resources
Things To Consider • Physician’s recommendation • Type of assistance needed now/future • Available residential openings and services • Financial resources
How To Choose • Get a list from Citizens for Better Care (CBC) • Ask others about their experiences • Involve the care receiver in the search and decision if possible • Call and visit potential LTC residences • Use check lists and other notes to document your search • Use state inspection reports and quality indicators
How Much Does A Nursing Home Cost? • The average cost for nursing home care is currently $60,000 a year. • The average stay in a nursing home is 19 months….$95,000 • Single individuals who move into a nursing home will spend themselves into poverty after only 13 weeks. • 50% of those persons who move into a nursing home, with a spouse at home, with deplete their resources within the first year.
How Much Does In-Home Care or Assisted Living* Cost? • Very limited home care can average $15,000 per year. • Full time home care could cost $130,000 to $185,000 annually. • Assisted Living currently ranges from $20,000 to $60,000 per year. *remember this is a marketing term
Who Pays? • Over 90% of care in the home and assisted living is paid for with private resources. • Over 50% of nursing home care comes from public funds.
Resources Next we will go through more detail about these payment sources: • Private Pay • Savings • Family Contributions • Long term care insurance • Reverse Mortgages • Older American Act and Kent County Senior Millage • Medicare and supplemental insurance • Medicaid • FIA Adult Home Help • MI Choice Waiver • Nursing Home
Private Sources 1.Private Pay – Income/Savings, Life Insurance 2.Reverse Mortgage, Home Equity 3. Long Term Care Insurance • age 65, approximate cost is $2,400 a year. • Some planners recommend that you not spend more than 7% of your income on LTC insurance.
Long Term Care Insurance Benefits to Consider • Daily benefit (how much) • Benefit period (length of time you receive benefits -1 year, 2 years, lifetime)? • Elimination period (deductible) time before begin collecting benefits • Inflation protection • No prior hospitalization required • Coverage not limited to skilled nursing home • Waiver of premium (does payment continue after you begin receiving services) • Home health care
Eligibility and Government Sources 4.Older American Act and Kent County Senior Millage • Priority to those most in need • List of services available from the Area Agency on Aging Of Western Michigan • Some cost share
Eligibility and Government Sources 5. Medicare and Supplemental Insurance • Eligibility = Prior Hospital Stay • Skilled Service • Maximum 100 days in skilled nursing home with a $105 required daily co-pay • Services covered • Nursing, Physical Therapy, Occupational Therapy, Speech Therapy
Eligibility and Government Sources 5.Continued: Medicare Supplemental Insurance There are 10 standardized Medicare supplemental insurance policies. • 8 cover skilled nursing facility daily co-pay • 4 cover limited at-home help if the beneficiary is receiving Medicare covered home health services • None cover basic long term nursing home care
Eligibility and Government Sources 6. Medicaid LTC- Categorical Eligibility and Financial Eligibility • Income • Assets Countable and Non countable (exempt) • Single $2,000 • Married both in nursing home $4,000 • Married, one person in a nursing home or in the MI Choice Waiver program up to $92,000
Eligibility and Government Sources Assets Declaration An Assets declaration is filed to protect assets for the community spouse.
Eligibility and Government Sources Exempt Assets One homestead, one car, household goods and personal effects, burial space
Eligibility and Government Sources Transfer of Assets--Divestment Before giving away or selling any assets below fair market value consult an attorney or financial planner who is an expert in Medicaid law
WhoPays For In Home Care? • Private Pay • FIA Home Help • Older American Act • Kent County Senior Millage • MI Choice Waiver • Limited long term care insurance • Limited-short time Medicare • Veterans
Who Pays For Residential (non nursing home) Assisted Living Care ? • Private Pay • Limited SSI
Who Pays Nursing Home Care? • 9.6% nursing home care (rehab) is paid by Medicare • 23.5 % of nursing home care is paid with private dollars • 67% of nursing home care is paid by Medicaid
Hope For The Future • More control and more flexibility • Payment not based on where you live, thereby allowing consumers more choice
